Recent advances in the understanding of urothelial tumorigenesis

ABSTRACT

Introduction

Patients with non-muscle-invasive bladder tumor suffer from disease recurrence following transurethral surgery even with intravesical pharmacotherapy, while muscle-invasive disease is often deadly. It is therefore critical to elucidate the underlying molecular mechanisms responsible for not only bladder tumor progression but also its tumorigenesis. Indeed, various molecules and/or signaling pathways have been suggested to contribute to the pathogenesis of bladder cancer.

Areas covered

We summarize the progress during the last few years on the initiation or development, but not progression, of urothelial cancer. The clinical implications of these available data, including prognostic significance and possible application for the prevention of the recurrence of non-muscle-invasive bladder tumors, are also discussed.

Expert opinion

Bladder cancer is a heterogeneous group of neoplasms. The establishment of personalized therapeutic options based on the molecular profile in each case should thus be considered. On that account, further accumulation of data on urothelial tumorigenesis is warranted to identify promising targets for the prevention of postoperative tumor recurrence or tumor development in otherwise high-risk patients.

KEYWORDS:

• Bladder cancer
• urothelial cancer
• tumorigenesis
• recurrence
• progression
• targeted therapy

Article highlights

• Bladder cancer remains a major public health issue, including the high rates of postoperative recurrence or progression in patients with non-muscle-invasive or muscle-invasive tumor, respectively.

• Despite tremendous progress in understanding the molecular basis of heterogeneous bladder cancer, further elucidation of the underlying mechanisms responsible for its pathogenesis is required.

• Recent observations regarding urothelial tumorigenesis, which is believed to be distinct from tumor progression and metastasis, documented in the last few years are summarized in the present article.

• Potential therapeutic intervention of these findings related to urothelial tumorigenesis includes the prevention of recurrent disease after transurethral surgery of non-muscle-invasive tumors.

• Further accumulation of data on urothelial tumorigenesis is still warranted to identify promising therapeutic targets.

Declaration of interest

H Miyamoto has received research funding from Astellas Scientific and Medical Affairs, Ferring Research Institute and Bristol Myers Squibb.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.